Adult Dosing
Malignant glioma and recurrent glioblastoma multiforme
- 7.7 mg x 8 wafers (total 61.6 mg) implanted intracranially
Note:
- If the resected cavity does not accommodate 8 wafers, place maximum number of wafers that fit within the cavity
- Wafers broken in half may be safely used, however wafers broken in >2 pieces should be discarded
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
See Supplemental Patient Information
- New or worsened seizures have been reported with carmustine therapy. Anti-seizure therapy should be optimized prior to treatment and patients should be monitored for seizures postoperatively
- Monitor patients closely for intracranial hypertension related to brain edema, inflammation, or necrosis of the brain tissue around the resection area
- Impaired neurosurgical wound healing (wound dehiscence, delayed wound healing, and subdural, subgleal, or wound effusions) has been reported with carmustine therapy. Post-operative monitoring for impaired wound healing is recommended
- Meningitis (bacterial and chemical) may occur in some patients treated with carmustine. Post-operative monitoring for signs of meningitis and other CNS infections is recommended
- Wafer migration into ventricular system may occur, resulting in obstructive hydrocephalus
- Carmustine can cause potential fetal harm if used during pregnancy. Advise females of child-bearing age to avoid pregnancy during treatment
Supplemental Patient Information
- Advise female patients of child-bearing age to use effective contraceptive methods to avoid pregnancy during treatment
- Advise male patients about the potential risk of infertility
Pregnancy Category:D
Breastfeeding: It is unknown if carmustine is excreted in human milk. Because of the potential for possible serious adverse reactions in nursing infants a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
